Τμήμα Ιατρικής (Δημοσ. Π.Π. σε περιοδικά)

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Open Access
Airway trauma : a review on epidemiology, mechanisms of injury, diagnosis and treatment
Prokakis, Christos; Dedeilias, Panagiotis; Filos, Kriton; Koletsis, Efstratios; Fligou, Foteini; Dougenis, Dimitrios; Προκάκης, Χρήστος; Δεδεήλιας, Παναγιώτης; Φίλος, Κρίτων; Κολέτσης, Ευστράτιος; Φλίγκου, Φωτεινή; Δουγενής, Δημήτρης
Τμήμα Ιατρικής (Δημοσ. Π.Π. σε περιοδικά)
Airway injuries are life threatening conditions. A very little number of patients suffering air injuries are transferred live at the hospital. The diagnosis requires a high index of suspicion based on the presence of non-specific for these injuries symptoms and signs and a thorough knowledge of the mechanisms of injury. Bronchoscopy and chest computed tomography with MPR and 3D reconstruction of the airway represent the procedures of choice for the definitive diagnosis. Endotracheal intubation under bronchoscopic guidance is the key point to gain airway control and appropriate ventilation. Primary repair with direct suture or resection and an end to end anastomosis is the treatment of choice for patients suffering from tracheobronchial injuries (TBI). The surgical approach to the injured airway depends on its location. Selected patients, mainly with iatrogenic injuries, can be treated conservatively as long as the injury is small (<2 cm), a secure and patent airway and adequate ventilation are achieved, and there are no signs of sepsis. Patients with delayed presentation airway injuries should be referred for surgical treatment. Intraoperative evaluation of the viability of the lung parenchyma beyond the site of stenosis/obstruction is mandatory to avoid unnecessary lung resection.
Open Access
Allergic inflammation does not impact chemical-induced carcinogenesis in the lungs of mice
(2011-12-02) Doris, Konstantinos; Karabela, Sophia P; Kairi, Chrysoula; Simoes, Davina CM; Roussos, Charis; Zakynthinos, Spyros G; Kalomenidis, Ioannis; Blackwell, Timothy S; Stathopoulos, Georgios T; Doris, Κωνσταντίνος; Καράμπελα, Σοφία Π; Καΐρη, Χρυσούλα; Simoes, Davina CM; Ρούσσος, Χάρης; Ζακυνθινός, Σπύρος Γ; Καλομενίδης, Ιωάννης; Blackwell, Timothy S; Σταθόπουλος, Γεώργιος Τ
Τμήμα Ιατρικής (Δημοσ. Π.Π. σε περιοδικά)
Although the relationship between allergic inflammation and lung carcinogenesis is not clearly defined, several reports suggest an increased incidence of lung cancer in patients with asthma. We aimed at determining the functional impact of allergic inflammation on chemical carcinogenesis in the lungs of mice. Methods Balb/c mice received single-dose urethane (1 g/kg at day 0) and two-stage ovalbumin during tumor initiation (sensitization: days -14 and 0; challenge: daily at days 6-12), tumor progression (sensitization: days 70 and 84; challenge: daily at days 90-96), or chronically (sensitization: days -14 and 0; challenge: daily at days 6-12 and thrice weekly thereafter). In addition, interleukin (IL)-5 deficient and wild-type C57BL/6 mice received ten weekly urethane injections. All mice were sacrificed after four months. Primary end-points were number, size, and histology of lung tumors. Secondary end-points were inflammatory cells and mediators in the airspace compartment. Results Ovalbumin provoked acute allergic inflammation and chronic remodeling of murine airways, evident by airspace eosinophilia, IL-5 up-regulation, and airspace enlargement. Urethane resulted in formation of atypical alveolar hyperplasias, adenomas, and adenocarcinomas in mouse lungs. Ovalbumin-induced allergic inflammation during tumor initiation, progression, or continuously did not impact the number, size, or histologic distribution of urethane-induced pulmonary neoplastic lesions. In addition, genetic deficiency in IL-5 had no effect on urethane-induced lung tumorigenesis. Conclusions Allergic inflammation does not impact chemical-induced carcinogenesis of the airways. These findings suggest that not all types of airway inflammation influence lung carcinogenesis and cast doubt on the idea of a mechanistic link between asthma and lung cancer.
Open Access
An in vitro study, evaluating the effect of sunitinib and/or lapatinib on two glioma cell lines
(2013-12-03) Giannopoulou, Efstathia; Dimitropoulos, Konstantinos; Argyriou, Andreas; Koutras, Angelos; Dimitrakopoulos, Fotinos; Kalofonos, Haralabos; Γιαννοπούλου, Ευσταθία; Δημητρόπουλος, Κωνσταντίνος; Αργυρίου, Ανδρέας; Κούτρας, Άγγελος; Δημητρακόπουλος, Φωτεινός; Καλόφωνος, Χαράλαμπος
Τμήμα Ιατρικής (Δημοσ. Π.Π. σε περιοδικά)
Aim: We sought to assess the effect of sunitinib and lapatinib applied either alone or in combination, on U87 and M059K glioma cells. Methods: Both cell lines were cultured as recommended by the manufacturer. Sunitinib and lapatinib were applied, either separately or in combination, in the cultured cells after cell attachment at doses of 10nM, 100nM, 1μM and 10 μM. To determine whether the agents affect the proliferation of glioma cells, the 3-[4,5-dimethylthiazol-2-yl]-2,5 dimethyltetrazolium bromide assay was used. Apoptosis was detected using annexin V/propidium iodide detection assay, migration assay was performed in 24-well microchemotaxis chambers. The release of MMPs into the culture medium of U87 and M059K cells was measured by zymography. Results: Both agents, administered either alone or in combination, decreased cell proliferation in a dose-dependent manner 48 h after their application in both cell lines. The inhibition of their combination was statistically different than the inhibition of each agent alone. Apoptosis was increased and migration of U87 and M059K cells was inhibited either by each agent alone or their combination. MMPs levels remained unaffected by the application of both agents in U87 cells. However, MMP-9 and MMP-2 levels were decreased 48h after treatment of M059K cells with sunitinib either alone or in combination with lapatinib. Conclusion: Sunitinib and/or lapatinib appear to exhibit significant effects on proliferation, apoptosis and migration of glioma cells. When applied alone, sunitinib appears to be a more potent inhibitor than lapatinib.
Open Access
An optical coherence tomography study of two new generation stents with 2 biodegradable polymer carrier, eluting paclitaxel vs. biolimus-A9
Davlouros, Periklis; Mavronasiou, Eleni; Xanthopoulou, Ioanna; Karantalis, Vasileios; Tsigkas, Grigorios; Hahalis, George; Alexopoulos, Dimitrios; Δαβλούρος, Περικλής; Μαυρονάσιου, Ελένη; Καρανταλής, Βασίλειος; Τσίγκας, Γρηγόριος; Χαλάλης, Γεώργιος; Ξανθοπούλου, Ιωάννα; Αλεξόπουλος, Δημήτριος
Τμήμα Ιατρικής (Δημοσ. Π.Π. σε περιοδικά)
Background: Tissue coverage and strut apposition of drug eluting stents (DES), which can be assessed with 21 optical coherence tomography (OCT), may be associated with late stent thrombosis (LST). 22 Methods: Prospective observational angiographic and OCT follow-up at 6 months post-implantation of a 23 biolimus-A9 eluting stent (BES) vs. a paclitaxel eluting stent (PES), with biodegradable polymer carriers. The 24 primary outcome was the percent difference of uncovered struts between BESs and PESs. 25 Results: A maximum likelihood model was used for analysis, to account for data clustering. Sixteen patients 26 were treated with BES (28 lesions/4530 struts) and 16 with PES (23 lesions/4450 struts). Overall, BESs 27 compared to PESs had more uncovered [0.41% vs. 0.21%, difference estimate (DE) 0.2 (95% CI, 0.06–0.34), 28 p=0.006], malapposed [0.18% vs. 0.04%, DE 0.14 (95% CI 0.05–0.23), p=0.003], uncovered and malapposed 29 [0.08% vs. 0.026%, DE 0.057 (95% CI 0.015–0.1), p=0.01] and protruding struts [0.23% vs. 0.04%, DE 0.185 (95% 30 CI 0.1–0.27), pb0.001], and significantly lower neointimal thickness (59.3± 28.2 μm vs. 201.7± 97.5, 31 pb0.001). None of the BESs was totally covered with neointima, in contrast to 5 (21.7%) PESs (p=0.01). 32 Thrombus was detected in 1 (3.6%) BES and 5 (21.7%) PESs (p=0.05); however, no patient experienced 33 clinical stent thrombosis. 34 Conclusion: Between two stents with biodegradable polymer, OCT demonstrated that BESs had more 35 uncovered and malapposed struts compared to PESs at 6 months. This difference might be partly attributed to 36 the more potent antiproliferative properties of biolimus-A9; however, its impact on clinical outcome and on 37 the risk of LST is yet to be determined.
Open Access
Baseline cerebral oximetry values in cardiac and vascular surgery patients: a prospective observational study
(2012-01-10) Baikoussis, Nikolaos G; Karanikolas, Menelaos; Siminelakis, Stavros; Matsagas, Miltiadis; Papadopoulos, Georgios; Μπαϊκούσσης, Νικόλαος; Καρανικόλας, Μενέλαος; Συμινελάκης, Σταύρος; Ματσάγκας, Μιλτιάδης; Παπαδόπουλος, Γεώργιος
Τμήμα Ιατρικής (Δημοσ. Π.Π. σε περιοδικά)
100 cardiac surgery patients and 57 carotid surgery patients enrolled. Compared to cardiac surgery, carotid endarterectomy patients were older (71.05 ± 8.69 vs. 65.72 ± 11.04, P < 0.001), with higher baseline INVOS (P < 0.007) and greater stroke frequency (P < 0.002). Diabetes and high cholesterol were more common in cardiac surgery patients. Right side INVOS values were strongly correlated with left-side values in carotid (r = 0.772, P < 0.0001) and cardiac surgery patients (r = 0.697, P < 0.0001). Diabetes and high cholesterol were associated with significantly (P < 0.001) lower INVOS and smoking was associated with higher INVOS values in carotid, but not in cardiac surgery patients. Age, sex, CVA history, Hypertension, CAD, Asthma, carotid stenosis side and surgery side were not related to INVOS. Multivariate analysis showed that diabetes is strongly associated with lower baseline INVOS values bilaterally (P < 0.001) and explained 36.4% of observed baseline INVOS variability in carotid (but not cardiac) surgery.
Open Access
Brucellosis presenting as piriformis myositis: a case report
(2011-12-02) Kraniotis, Pantelis; Marangos, Markos; Lekkou, Alexandra; Romanos, Odysseas; Solomou, Ekaterini; Κρανιώτης, Παντελής; Μαραγκός, Μάρκος; Λέκκου, Αλεξάνδρα; Ρωμανός, Οδυσσέας; Σολωμού, Αικατερίνη
Τμήμα Ιατρικής (Δημοσ. Π.Π. σε περιοδικά)
Myositis is a rare bacterial muscle infection. Involvement of the piriformis muscle has been rarely reported in the literature. In this report we describe a case of piriformis myositis due to Brucella melitensis, which to the best of our knowledge is the first such case presented in the literature.
Open Access
Correlation between the personal and social performance scale (PSP) and the positive and negative syndrome scale (PANSS) in a Greek sample of patients with schizophrenia
Jelastopulu, Eleni; Giourou, Evangelia; Merekoulias, Giorgos; Mestousi, Angeliki; Moratis, Eleftherios; Alexopoulos, Evangelos C; Τζελαστοπούλου, Ελένη; Γιούρου, Ευαγγελία; Μερεκούλιας, Γιώργος; Μεστούση, Αγγελική; Μωράτης, Ελευθέριος; Αλεξόπουλος, Ευάγγελος Γ.
Τμήμα Ιατρικής (Δημοσ. Π.Π. σε περιοδικά)
Background: Psychosocial dysfunction is one of schizophrenia’s core features, often leading to a deprecation of independent living and significant failure to maintain a competent quality of life. Cognitive and occupational performance as well as psychosocial functioning is moreover recognized as determinants of treatment response. Therefore, the elaboration of measures regarding social performance besides scales that assess psychopathology is essential. The Personal and Social Performance (PSP) scale has been found to be as much valid as reliable for assessing social functioning in the acute and stable stage of schizophrenia. The aim of this study was to estimate the correlation between the PSP and Positive and Negative Syndrome Scale (PANSS) (convergent validity) in patients with schizophrenia during routine clinical practice. Methods: A longitudinal study with a six-month follow-up is presented. Correlation between the PSP scale and the Positive and Negative Syndrome Scale (PANSS) was conducted in a Greek sample of 2010 patients with schizophrenia in outpatient setting in two successive visits. PANSS and PSP scales were used for the assessment of psychopathological symptoms and social and personal functioning. Results: The PSP subscales scores were well correlated with each other with Spearman correlation coefficients (r) ranging from 0.56 to 0.76 on both visits in three out of the four main areas, whereas in the category of “disturbing and aggressive behavior” the correlations were lower but still significant. Furthermore, total PSP score showed high association to PANSS total score in the first (r = −0.59) as well as in the second visit (r = −0.50). Regression analysis showed that one point decrease of PANSS’s total score is associated with a 0.42 points increase on the PSP scale. PSP and PANSS scales exhibited high convergent validity. Conclusions: The PSP could provide additional valuable information in the assessment of schizophrenia related social functioning and treatment response.
Open Access
Diabetes mellitus and platelet reactivity in patients under prasugrel or ticagrelor treatment : an observational study
Alexopoulos, Dimitrios; Stavrou, Katerina; Perperis, Aggelos; Xanthopoulou, Ioanna; Vogiatzi, Chrysoula; Vlassopoulou, Niki; Pentara, Ioanna; Αλεξόπουλος, Δημήτριος; Σταύρου, Κατερίνα; Περπερής, Άγγελος; Ξανθοπούλου, Ιωάννα; Βογιατζή, Χρυσούλα; Βλασσοπούλου, Νίκη; Πενταρά, Ιωάννα
Τμήμα Ιατρικής (Δημοσ. Π.Π. σε περιοδικά)
Background: The influence of diabetes mellitus (DM) on platelet reactivity (PR) in prasugrel or ticagrelor treated patients is not well studied. Methods: In an observational study involving 777 patients with acute coronary syndrome undergoing percutaneous coronary intervention treated by either prasugrel 10 mg od (n = 315) or ticagrelor 90 mg bid (n = 462), platelet function was assessed using the VerifyNow P2Y12 function assay (in PRU) at one month post intervention. Results: In the overall population, ticagrelor and insulin-treated DM affected PR, with a decrease in log by 0.88 (corresponding to a 58 % decrease in PR) compared to prasugrel-treated patients (p < 0.001), and an increase in log by 0.26 (corresponding to a 30 % increase in PR) compared to non-diabetic patients (p = 0.01), respectively. PR in prasugrel-treated patients differed significantly by DM status: 70.0 (36.3-113.0) in non-diabetic vs 69.0 (44.5-115.3) in non insulin-treated diabetic vs 122.0 (69.0-161.0) in insulin-treated diabetic patients, p for trend = 0.01. No differences were observed in ticagrelor-treated patients. By multivariate analysis, in prasugrel-treated patients insulin-treated DM was the only factor predicting PR, with log of PR increased by 0.42 (corresponding to a 52 % increase in PR) compared to non-diabetic patients (p = 0.001). No factor was found to affect PR in ticagrelor-treated patients. Conclusions: Patients with insulin-treated DM treated with prasugrel post PCI have higher PR, than patients without DM or non insulin-treated diabetic patients treated with this drug. Ticagrelor treated patients have overall lower PR than patients on prasugrel, independent of DM status or insulin treatment.
Open Access
Experience and limited lighting may affect sleepiness of tunnel workers
Lykouras, Dimosthenis; Patouchas, Dimitrios; Sampsonas, Fotis; Faliagka, Evanthia; Spiropoulos, Kostas; Karkoulias, Kiriakos; Lakoumentas, John; Tranou, Magdalini-Konstantina; Tsakalidis, Athanasios; Λυκούρας, Δημοσθένης; Πατούχας, Δημήτριος; Σαμψώνας, Φώτης; Φαλιάγκα, Ευανθία; Σπυρόπουλος, Κώστας; Καρκούλιας, Κυριάκος; Λακουμέντας, Γιάννης; Τρανού, Μαγδαληνή Κωνσταντίνα; Τσακαλίδης, Αθανάσιος
Τμήμα Ιατρικής (Δημοσ. Π.Π. σε περιοδικά)
Working on shifts, especially on a night shift, influences the endogenous sleep regulation system leading to diminished sleep time and increased somnolence. We attempted to evaluate the impact of shifts on sleepiness and correlate the sleepiness score to the experience in a shift schedule. Materials and methods: This cross-sectional study consists of 42 male and 2 female workers involved in a tunnel construction. They underwent spirometry, pulse oximetry and were asked to complete the Epworth Sleepiness Scale questionnaire. Results: Statistical analysis revealed that workers of lower Epworth had a mean age of 43.6 years, compared to the mean age of 36.4 years of workers with higher Epworth. Furthermore, workers of lower Epworth were characterized by a mean number of shift years equal to 14.8, while those of higher Epworth possessed a mean number of shift years equal to 8. The shift schedule did not reveal any statistically significant correlation. Conclusions: Workers employed for a longer time had diminished sleepiness. However, there is no relationship between night shifts and sleepiness, possibly because of exposure to artificial lighting in the construction site.
Open Access
Global avian influenza outbreaks 2010-2016 : a systematic review of their distribution, avian species and virus subtype
Chatziprodromidou, Ioanna; Arvanitidou, Malamatenia; Guitian, Javier; Apostolou, Thomas; Vantarakis, George; Vantarakis, Apostolos; Χατζηπροδρομίδου, Ιωάννα; Αρβανιτίδου, Μαλαματένια; Guitian, Javier; Αποστόλου, Θωμάς; Βανταράκης, Γεώργιος; Βανταράκης, Απόστολος
Τμήμα Ιατρικής (Δημοσ. Π.Π. σε περιοδικά)
BACKGROUND: We conducted a systematic review to investigate avian influenza outbreaks and to explore their distribution, upon avian influenza subtype, country, avian species and other relating details as no comprehensive epidemiological analysis of global avian influenza outbreaks from 2010 to 2016 exists. METHODS: Data was collated from four databases (Scopus, Web of Science Core Correlation, PubMed and SpringerLink electronic journal) and a global electronic reporting system (ProMED mail), using PRISMA and ORION systematic approaches. One hundred seventy three avian influenza virus outbreaks were identified and included in this review, alongside 198 ProMED mail reports. RESULTS: Our research identified that the majority of the reported outbreaks occurred in 2016 (22.2%). These outbreaks were located in China (13.6%) and referred to commercial poultry farms (56.1%). The most common subtype reported in these outbreaks was H5N1 (38.2%), while almost 82.5% of the subtypes were highly pathogenic avian influenza viruses. There were differences noticed between ProMED mail and the scientific literature screened. CONCLUSIONS: Avian influenza virus has been proved to be able to contaminate all types of avian species, including commercial poultry farms, wild birds, backyard domestic animals, live poultry, game birds and mixed poultry. The study focused on wet markets, slaughterhouses, wild habitats, zoos and natural parks, in both developed and developing countries. The impact of avian influenza virus seems disproportionate and could potentially burden the already existing disparities in the public health domain. Therefore, a collaboration between all the involved health sectors is considered to be more than necessary.
Open Access
HDAC3 role in medication consumption in medication overuse headache patients : a pilot study
Pisanu, Claudia; Congiu, Donatella; Squassina, Alessio; Corbelli, Ilenia; Del Zompo, Maria; Caproni, Stefano; Cupini, Letizia; Patrinos, George; Calabresi, Paolo; Sarchielli, Paola; Πατρινός, Γεώργιος
Τμήμα Ιατρικής (Δημοσ. Π.Π. σε περιοδικά)
Background: Medication overuse headache (MOH) is a common and debilitating disorder characterized by generation, perpetuation, and persistence of intense chronic migraine, caused by overuse of analgesics, triptans, or other acute headache compounds. It has been suggested that MOH could share some pathogenetic mechanisms with other kinds of drug addiction. In this regard, histone deacetylases 3 (HDAC3) seems to have a role in the memory processes involved in extinction of drug-seeking behavior in animal models. HDAC3 is inhibited by sodium valproate, a drug with proven efficacy in MOH. Recent evidence suggests an involvement of genetic factors in predisposition to medication overuse. Results: In this association study, we sequenced all exons, intron/exon junctions, and 3′-5′UTR regions of HDAC3 in 23 MOH patients to investigate its role in medication overuse. Associations between genotypes with continuous and dichotomous clinical characteristics were tested by multivariate analysis and Fisher’s exact test, respectively. Sequencing of HDAC3 revealed six single-nucleotide polymorphisms. The G allele of rs2530223 was significantly associated with the number of acute medications/month used and with the number of days/month in which medications were used (p=0.006 and p=0.007, respectively), but neither with headache frequency or intensity. None of the single-nucleotide polymorphisms (SNPs) was associated with clinical characteristics or response to sodium valproate. Conclusions: HDAC3 could be implicated in excessive medication consumption in MOH patients. Our preliminary findings provide support for the need of further investigation on larger independent samples to confirm and extend the role of HDAC3 in medication overuse headache.
Open Access
Higher intrinsic network excitability in ventral compared with the dorsal hippocampus is controlled less effectively by GABAB receptors
Papatheodoropoulos, Costas; Παπαθεοδωρόπουλος, Κώστας
Τμήμα Ιατρικής (Δημοσ. Π.Π. σε περιοδικά)
Background: Elucidating specializations of the intrinsic neuronal network between the dorsal and the ventral hippocampus is a recently emerging area of research that is expected to help us understand the mechanisms underlying large scale functional diversification along the hippocampus. The aim of this study was to characterize spontaneous network activity between the dorsal and the ventral hippocampus induced under conditions of partial or complete blockade of GABAergic inhibition (i.e. disinhibition). Results: Using field recordings from the CA3 and CA1 fields of hippocampal slices from adult rats I found that ventral compared with dorsal hippocampus slices displayed higher propensity for and higher frequency of occurrence of spontaneous field potentials (spfps) at every level of disinhibition. Also NMDA receptor-depended spfps (spfps-nmda) occurred with higher probability more frequently and were larger in the ventral compared with the dorsal hippocampus. Importantly, blockade of GABAB receptors produced a stronger effect in enhancing the probability of generation of spfps and spfps-nmda in the dorsal compared with the ventral hippocampal slices and increased spfps-nmda only in dorsal slices. Conclusion: These results demonstrate a higher intrinsic neuronal excitability of the ventral compared with the dorsal local circuitry with the considerable contribution of NMDA receptors. Furthermore, the GABAB receptors control the total and the NMDA receptor-dependent excitation much less effectively in the ventral part of the hippocampus. It is proposed that NMDA and GABAB receptors significantly contribute to differentiate local network dynamics between the dorsal and the ventral hippocampus with important implications in the information processing performed along the long hippocampal axis.
Open Access
Intravenous levosimendan-norepinephrine combination during off-pump coronary artery bypass grafting in a hemodialysis patient with severe myocardial dysfunction
(2012-01-10) Papadopoulos, Georgios; Baikoussis, Nikolaos G; Tzimas, Petros; Siminelakis, Stavros N; Karanikolas, Menelaos; Παπαδόπουλος, Γεώργιος; Μπαϊκούσσης, Νικόλαος; Τζίμας, Πέτρος; Συμινελάκης, Σταύρος; Καρανικόλας, Μενέλαος
Τμήμα Ιατρικής (Δημοσ. Π.Π. σε περιοδικά)
This the case of a 63 year-old man with end-stage renal disease (on chronic hemodialysis), unstable angina and significantly impaired myocardial contractility with low left ventricular ejection fraction, who underwent off-pump one vessel coronary bypass surgery. Combined continuous levosimendan and norepinephrine infusion (at 0.07 μg/kg/min and 0.05 μg/kg/min respectively) started immediately after anesthesia induction and continued for 24 hours. The levosimendan/norepinephrine combination helped maintain an appropriate hemodynamic profile, thereby contributing to uneventful completion of surgery and postoperative hemodynamic stability. Although levosimendan is considered contraindicated in ESRD patients, this case report suggests that combined perioperative levosimendan/norepinephrine administration can be useful in carefully selected hemodialysis patients with impaired myocardial contractility and ongoing myocardial ischemia, who undergo off-pump myocardial revascularization surgery.
Open Access
Investigating the international prices of wheat and rice
Rezitis, Anthony; Pachis, Dimitris; Ntinou, Anastasia; Ρεζίτης, Αντώνιος; Παχής, Δημήτρης; Ντίνου, Αναστασία
Τμήμα Ιατρικής (Δημοσ. Π.Π. σε περιοδικά)
This paper investigates the international quarterly prices of wheat and rice from 1983(1) to 2012(4). The empirical analysis takes place with the structural time series methodology which decomposes the price series into their trend, cycle, seasonal and irregular components. The empirical results indicate that wheat prices present cyclical behavior while rice prices except for cyclicality are mainly governed by the irregular component. The results strain the importance of treating wheat and rice like two distinct commodities that require country specific and commodity specific policy measures. Finally, the impact of the shrinking Chinese grain stocks after 2002 is proposed as an important factor that resulted in the 2008 price spike.
Open Access
Mutant KRAS promotes malignant pleural effusion formation
Agalioti, Theodora; Giannou, Anastasios; Krontira, Anthi; Kanellakis, Nikolaos; Kati, Danai; Vreka, Malamati; Pepe, Mario; Spella, Magda; Lilis, Ioannis; Zazara, Dimitra; Nikolouli, Eirini; Spiropoulou, Nikolitsa; Papadakis, Andreas; Papadia, Konstantina; Voulgaridis, Apostolos; Stamou, Panagiota; Meiners, Silke; Eickelberg, Oliver; Snyder, Linda; Antimisiaris, Sophia; Kardamakis, Dimitrios; Psallidas, Ioannis; Marazioti, Antonia; Stathopoulos, Georgios; Αγαλιώτη, Θεοδώρα; Γιάννου, Αναστάσιος; Κροντηρά, Ανθή; Κανελλάκης, Νικόλαος; Κατή, Δανάη; Βρεκά, Μαλαματή; Σπέλλα, Μάγδα; Λιλής, Ιωάννης; Ζαζάρα, Δήμητρα; Νικολούλη, Ειρήνη; Σπυροπούλου, Νικολίτσα; Παπαδάκης, Ανδρέας; Παπαδιά, Κωνσταντίνα; Βουλγαρίδης, Απόστολος; Χαροκόπος, Βαγγέλης; Στάμου, Παναγιώτα; Αντιμησιάρη, Σοφία; Καρδαμάκης, Δημήτριος; Ψαλλίδας, Ιωάννης; Μαραζιώτη, Αντωνία; Σταθόπουλος, Γεώργιος
Τμήμα Ιατρικής (Δημοσ. Π.Π. σε περιοδικά)
Malignant pleural effusion (MPE) is the lethal consequence of various human cancers metastatic to the pleural cavity. However, the mechanisms responsible for the development of MPE are still obscure. Here we show that mutant KRAS is important for MPE induction in mice. Pleural disseminated, mutant KRAS bearing tumour cells upregulate and systemically release chemokine ligand 2 (CCL2) into the bloodstream to mobilize myeloid cells from the host bone marrow to the pleural space via the spleen. These cells promote MPE formation, as indicated by splenectomy and splenocyte restoration experiments. In addition, KRAS mutations are frequently detected in human MPE and cell lines isolated thereof, but are often lost during automated analyses, as indicated by manual versus automated examination of Sanger sequencing traces. Finally, the novel KRAS inhibitor deltarasin and a monoclonal antibody directed against CCL2 are equally effective against an experimental mouse model of MPE, a result that holds promise for future efficient therapies against the human condition.
Open Access
Myeloid-derived interleukin-1β drives oncogenic KRAS-NF-κΒ addiction in malignant pleural effusion
Marazioti, Antonia; Lilis, Ioannis; Vreka, Malamati; Apostolopoulou, Hara; Kalogeropoulou, Argyro; Giopanou, Ioanna; Giotopoulou, Georgia; Krontira, Anthi; Iliopoulou, Marianthi; Kanellakis, Nikolaos; Agalioti, Theodora; Giannou, Anastasios; Jones-Paris, Celestial; Iwakura, Yoichiro; Kardamakis, Dimitrios; Blackwell, Timothy; Taraviras, Stavros; Spella, Magda; Stathopoulos, Georgios; Μαραζιώτη, Αντωνία; Λιλής, Ιωάννης; Βρεκά, Μαλαματή; Αποστολοπούλου, Χαρά; Καλογεροπούλου, Αργυρώ; Γιοπάνου, Ιωάννα; Γιωτοπούλου, Γεωργία; Κροντηρά, Ανθή; Ηλιοπούλου, Μαριάνθη; Κανελλάκης, Νικόλαος; Αγαλιώτη, Θεοδώρα; Γιάννου, Αναστάσιος; Καρδαμάκης, Δημήτριος; Ταραβήρας, Σταύρος; Σπέλλα, Μάγδα; Σταθόπουλος, Γεώργιος
Τμήμα Ιατρικής (Δημοσ. Π.Π. σε περιοδικά)
Malignant pleural effusion (MPE) is a frequent metastatic manifestation of human cancers. While we previously identified KRAS mutations as molecular culprits of MPE formation, the underlying mechanism remained unknown. Here, we determine that non-canonical IKKα-RelB pathway activation of KRAS-mutant tumor cells mediates MPE development and this is fueled by host-provided interleukin IL-1β. Indeed, IKKα is required for the MPE-competence of KRAS-mutant tumor cells by activating non-canonical NF-κB signaling. IL-1β fuels addiction of mutant KRAS to IKKα resulting in increased CXCL1 secretion that fosters MPE-associated inflammation. Importantly, IL-1β-mediated NF-κB induction in KRAS-mutant tumor cells, as well as their resulting MPE-competence, can only be blocked by co-inhibition of both KRAS and IKKα, a strategy that overcomes drug resistance to individual treatments. Hence we show that mutant KRAS facilitates IKKα-mediated responsiveness of tumor cells to host IL-1β, thereby establishing a host-to-tumor signaling circuit that culminates in inflammatory MPE development and drug resistance.
Open Access
NRAS destines tumor cells to the lungs
Γιάννου, Αναστάσιος; Μαραζιώτη, Αντωνία; Κανελλάκης, Νικόλαος; Γιοπάνου, Ιωάννα; Λίλης, Ιωάννης; Ζαζάρα, Δήμητρα; Νταλιάρδα, Γιαννούλα; Κατή, Δανάη; Αρμένης, Βασίλειος; Γιωτοπουλου, Γεωργία; Κροντηρά, Ανθή; Λιανου, Μαρίνα; Αγαλιώτη, Θεοδώρα; Βρέκα, Μαλαματή; Παπαγεωργοπούλου, Μαρία; Φούζας, Σωτήριος; Καρδαμάκης, Δημήτριος; Ψαλλίδας, Ιωάννης; Σταθόπουλος, Γεώργιος; Σπέλλα, Μάγδα; Giannou, Anastasios; Marazioti, Antonia; Kanellakis, Nikolaos; Giopanou, Ioanna; Lilis, Ioannis; Zazara, Dimitra; Ntaliarda, Giannoula; Kati, Danai; Armenis, Vasileios; Giotopoulou, Georgia; Krontira, Anthi; Lianou, Marina; Agalioti, Theodora; Vreka, Malamati; Papageorgopoulou, Maria; Fouzas, Sotirios; Kardamakis, Dimitrios; Psallidas, Ioannis; Spella, Magda; Stathopoulos, Georgios
Τμήμα Ιατρικής (Δημοσ. Π.Π. σε περιοδικά)
The lungs are frequently affected by cancer metastasis. Although NRAS mutations have been associated with metastatic potential, their exact role in lung homing is incompletely understood. We cross-examined the genotype of various tumor cells with their ability for automatic pulmonary dissemination, modulated NRAS expression using RNA interference and NRAS overexpression, identified NRAS signaling partners by microarray, and validated them using Cxcr1- and Cxcr2-deficient mice. Mouse models of spontaneous lung metastasis revealed that mutant or overexpressed NRAS promotes lung colonization by regulating interleukin-8-related chemokine expression, thereby initiating interactions between tumor cells, the pulmonary vasculature, and myeloid cells. Our results support a model where NRAS-mutant, chemokine-expressing circulating tumor cells target the CXCR1-expressing lung vasculature and recruit CXCR2-expressing myeloid cells to initiate metastasis. We further describe a clinically relevant approach to prevent NRAS-driven pulmonary metastasis by inhibiting chemokine signaling. In conclusion, NRAS promotes the colonization of the lungs by various tumor types in mouse models. IL-8-related chemokines, NRAS signaling partners in this process, may constitute an important therapeutic target against pulmonary involvement by cancers of other organs.
Open Access
Osteolytic lesions (brown tumors) of primary hyperparathyroidism misdiagnosed as multifocal giant cell tumor of the distal ulna andradius
Panagopoulos, A.; Tatani, I.; Kourea, H. P.; Kokkalis, Z.T.; Panagopoulos, K.; Megas, P.; Παναγόπουλος, Ανδρέας; Τατάνη, Ειρήνη; Κουρέα, Ελένη; Κόκκαλης, Ζήνων; Παναγόπουλος, Κωνσταντίνος; Μέγας, Παναγιώτης
Τμήμα Ιατρικής (Δημοσ. Π.Π. σε περιοδικά)
BACKGROUND: Brown tumors represent a rare clinical manifestation reported in approximately 3% of patients with primary hyperparathyroidism and correspond to radiologically osteolytic lesions with well-defined borders in different parts of the skeleton. CASE PRESENTATION: We report the case of a 53-year-old white man who presented to our hospital with osteolytic lesions of his distal ulna and radius, causing pain and swelling of 2-month duration. A subsequent biopsy revealed histological features consistent with giant cell tumor and a complete resection of his distal ulna was followed, along with curettage and cementoplasty of the distal radial metaphysis. Two weeks later, he was re-admitted with diffuse musculoskeletal soreness, anorexia, constipation, nausea, and localized abdominal pain and multiple osteolytic lesions on plain radiographs. A histopathological examination of the ulna and radius specimens showed similar findings and, given the multifocality, brown tumors related to primary or secondary hyperparathyroidism was included in the differential diagnosis. A laboratory examination showed high total serum calcium (14.5 mg/dl) and low serum phosphorus and 25-hydroxyvitamin D levels. Primary hyperparathyroidism was suspected and confirmed by the elevated parathyroid hormone levels of 1453 pg/mL. At radiological work-up, using computed tomography, ultrasonography, and parathyroid subtraction technetium-99m sestamibi scintigraphy, a 4.5 × 2.5 × 3.2 cm mass emanating from the right lobe of his thyroid gland was detected, displaying extensive uptake in the right lower parathyroid gland. After appropriate medical support including hyperhydration and high doses of diuretics and diphosphonates, his laboratory profile normalized and he underwent total thyroidectomy with removal of the parathyroid glands. Our patient is now recovering 12 months after surgery, with normal values of serum parathyroid hormone and calcium levels. The lytic bone lesions have almost disappeared and no other additional orthopedic intervention was necessary. CONCLUSIONS: The present case report emphasizes the need of inclusion of brown tumors in the differential diagnosis of multifocal osteolytic bone lesions, in order to avoid harmful surgical interventions. Laboratory testing of serum phosphate, calcium levels, and parathyroid hormone levels should always be included in the routine survey of patients with multifocal osteolytic lesions.
Open Access
Pattern dystrophies in patients treated with deferoxamine. Report of two cases and review of the literature
Georgakopoulos, Constantine; Tsapardoni, Foteini; Kostopoulou, Elli; Makri, Olga; Γεωργακόπουλος, Κωνσταντίνος; Τσαπαρδώνη, Φωτεινή; Κωστοπούλου, Έλλη; Μακρή, Όλγα
Τμήμα Ιατρικής (Δημοσ. Π.Π. σε περιοδικά)
Background: Deferoxamine (DFO) is one of the most commonly used chelation treatments for transfusional hemosiderosis. Pattern dystrophies constitute a distinct entity of retinal disorders that has been occasionally identified in association with deferoxamine. Case presentation: We report two cases of bilateral macular pattern dystrophy in transfusion dependent patients undergoing chronic chelation therapy with deferoxamine due to thalassemias. Our patients were evaluated with multimodal imaging and the results are presented. Both patients had normal cone and rod responses in the full-field electroretinogram and continued the prescribed chelation therapy, after hematology consult. The patients were followed up every 3 months for 2 and 4 years respectively for possible deterioration. Their best corrected visual acuity remained stable with no anatomic change on Optical Coherence Tomography findings. Conclusion: Multimodal imaging of our patients allowed a better evaluation and possibly earlier detection of the DFO- related changes. Screening and close follow up of patients under chronic chelating therapy is important in order to promptly diagnose and manage possible toxicity either with discontinuation of the offending agent or dose modification.
Open Access
Phagocytic ability of neutrophils and monocytes in neonates.
(2011-10-26) Φίλιας, Αθανάσιος; Θεοδώρου, Γεώργιος; Μουζοπούλου, Σοφία; Βαρβαρίγου, Αναστασία; Μανταγός, Στέφανος; Καρακάντζα, Μαρίνα; Filias, Athanasios; Theodorou, Georgios; Mouzopoulou, Sofia; Varvarigou, Anastasia; Mantagos, Stephanos; Karakantza, Marina
Τμήμα Ιατρικής (Δημοσ. Π.Π. σε περιοδικά)
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